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Still, side effects from B12 supplements are possible, especially at higher doses, and include: Headache Nausea Vomiting Fatigue Weakness Diarrhea Tingling in the hands and feet Nasal spray Vitamin B12 is also available in a nasal spray

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A high dosage of B12 is around 500-1,000 mcg a day, either given via oral supplements or B12 injections

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This uncertainty is recognised in laboratory medicine guidance from bodies such as the Association for Clinical Biochemistry and Laboratory Medicine (ACB) and the Royal College of Pathologists (RCPath)